Respiratory weakness is associated with limb weakness and delayed weaning in critical illness*

Jonghe, Bernard De; Bastuji‐Garin, Sylvie; Durand, Marie-Christine; Malissin, Isabelle; Rodrigues, Pablo Felipe; Cerf, Charles; Outin, Hervé; Sharshar, Tarek

doi:10.1097/01.ccm.0000281450.01881.d8

Cited by 483 publications

(432 citation statements)

References 38 publications

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“…Bailey et al (2007) stated that patients who received MV for a period longer than four days were at considerable risk of such debilitation. Prolonged MV has been defined by some as >48 hours and by others as ≥7 days (De Jonghe et al 2007;Chang et al 2005). The duration of LOS reported in this study was substan tially longer than that reported by some authors (Orwelius et Subjects were found to experience problems in all five items of the EQ 5D at six months with some reporting extreme problems in the pain/discomfort and anxiety/depression items.…”

Section: Discussioncontrasting

confidence: 53%

Health related quality of life of survivors of trauma six months after discharge

Schneiderman

Aswegen

Becker

2013

South African Journal of Physiotherapy

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Section: Discussioncontrasting

confidence: 53%

Health related quality of life of survivors of trauma six months after discharge

Schneiderman

Aswegen

Becker

2013

South African Journal of Physiotherapy

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“…After prolonged bed rest, PMV patients may suffer from respiratory muscle weakness, limb muscle atrophy, and decreased ability to perform activities of daily living (ADL). 2 The complications of PMV, such as barotrauma and/or ventilator-induced diaphragm dysfunction can also further impair pulmonary mechanics. These factors together may lead to increased mortality rate, MV weaning failure rate, hospital stay, and impaired physical functional status in the PMV population.…”

Section: Introductionmentioning

confidence: 99%

Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation

et al. 2012

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BACKGROUND:The functional status and outcomes in patients with prolonged mechanical ventilation (PMV) are often limited by poor endurance and pulmonary mechanics, which result from the primary diseases or prolonged time bedridden. We evaluate the impact of exercise training on pulmonary mechanics, physical functional status, and hospitalization outcomes in PMV patients. METHODS: Twenty-seven subjects with PMV in our respiratory care center (RCC) were divided randomly into an exercise training group (n ‫؍‬ 12) and a control group (n ‫؍‬ 15). The exercise program comprised 10 sessions of exercise training. The measurement of pulmonary mechanics and physical functional status (Functional Independence Measurement and Barthel index) were performed pre-study and post-study. The hospitalization outcomes included: days of mechanical ventilation, hospitalization days, and weaning and mortality rates during RCC stay. RESULTS: The training group had significant improvement in tidal volume (143.6 mL vs 192.5 mL, P ‫؍‬ .02) and rapid shallow breathing index after training (162.2 vs 110.6, P ‫؍‬ .009). No significant change was found in the control group except respiratory rate. Both groups had significant improvement in functional status during the study. However, the training group had greater changes in FIM score than the control group (44.6 vs 34.2, P ‫؍‬ .024). The training group also had shorter RCC stay and higher weaning and survival rates than the control group, although no statistical difference was found. CONCLUSIONS: Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training. The application of exercise training may be helpful for PMV patients to improve hospitalization outcomes.

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“…Patients who required at least mechanical ventilation were screened daily for awakening and comprehension using five simple verbal commands as previously described [13,14]. Patients were enrolled in the study and hormonal assays were performed on the first day when awakening and comprehension were satisfactory (day 1).…”

Section: Methodsmentioning

confidence: 99%

Hormonal status in protracted critical illness and in-hospital mortality

et al. 2011

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IntroductionThe aim of this study was to determine the relationship between hormonal status and mortality in patients with protracted critical illness.MethodsWe conducted a prospective observational study in four medical and surgical intensive care units (ICUs). ICU patients who regained consciousness after 7 days of mechanical ventilation were included. Plasma levels of insulin-like growth factor 1 (IGF-1), prolactin, thyroid-stimulating hormone, follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, testosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS) and cortisol were measured on the first day patients were awake and cooperative (day 1). Mean blood glucose from admission to day 1 was calculated.ResultsWe studied 102 patients: 65 men and 37 women (29 of the women were postmenopausal). Twenty-four patients (24%) died in the hospital. The IGF-1 levels were higher and the cortisol levels were lower in survivors. Mean blood glucose was lower in women who survived, and DHEA and DHEAS were higher in men who survived.ConclusionsThese results suggest that, on the basis of sex, some endocrine or metabolic markers measured in the postacute phase of critical illness might have a prognostic value.

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Respiratory weakness is associated with limb weakness and delayed weaning in critical illness*

Abstract: Respiratory and limb muscle strength are both altered after 1 wk of mechanical ventilation. Respiratory muscle weakness is associated with delayed extubation and prolonged ventilation. In our study, septic shock is a contributor to respiratory weakness.

Cited by 483 publications

References 38 publications

Health related quality of life of survivors of trauma six months after discharge

Health related quality of life of survivors of trauma six months after discharge

Effects of Exercise Training on Pulmonary Mechanics and Functional Status in Patients With Prolonged Mechanical Ventilation

Hormonal status in protracted critical illness and in-hospital mortality

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